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Therex final

Components of TherEx Balance, Coordination, cardiopulmonary control, flexibility + mobility, muscle performance, neuromuscular control, stability, posture
model of disablement pathology --> impairment --> dysfunction --> disability
Pathology disruption in body's homeostasis. e.g. inflammatory process, change in LT curve of muscle, wound healing + scar formation
impairments the consequences of pathologic conditions. musculoskeletal, neuromuscular, cardiovascular/pulmonary, endurance, integumentary
Functional limitations inability for a person to perform functionally as a whole (ADLs)
Disbaility individual functioning within the social realm.
risk factors biological, behavioral, physical environment, socioeconomic.
functional excursion the distance a muscle can shorten after its been elongated to its max
active insufficiency false manual muscle test reading
passive insufficiency effects goniometric reading
Active assisted ROM assistance provided by outside force either manually or mechanically because the prime movers need help to complete the motion
indications for PROM acute/inflamed tissue 2-6 days post injury or surgery, also when AROM is contraindicated
PROM WILL NOT: prevent muscle atrophy, increase strength or endurance, assist circulation as well as AROM/voluntary contraction
types of contractures Myostatic (stretch gently) + pseudomyostatic (arthrogenic + periarticular): fibrotic and irreversable
Determinants of Stretching Alignment + stabilization, intensity, duration, speed, frequency, mode, neuromuscular inhibition.
How long to hold stretched position 15-30 secs add 10 secs for every 10 yrs increase in age
CI's to stretching Advanced age, fracture, osteoporosis, acute local inflammation, hematoma, myositis ossificans, integrity of jt. hypermobility, functional contractures, sharp acute pain with movement, if shortened tissue provides jt. stability
Stretch around the elbow? watch out for heterotrophic ossification, edema, weak muscles
NM inhibition hold relax, contract relax, distraction, contraction of contralateral extremity
functional strength ability of the nm system to produce, reduce, or control forces during functional activities in a smooth coordinated manner
benefits of resistance exercise enhance muscle performance, increased CT strength, greater bone density, reduced risk of soft tissue injury, enhanced physical performance, enhanced physical well being
principles of training overload principle, SAID principle, Reversibility principle
What are some signs of muscle fatigue?` tremulousness, jerky movements, unable to complete ROM, substitute motions, decline in peak torque
What are the determinants of resistance exercise? Alignment, stabilization, intensity, volume, exercise order, frequency, rest interval, duration, mode of exercise, velocity, periodization, integration with functional activities,
what are the CI's to resistive exercise? inflammation, pain, cardiac/resp disease
Training zone after established baseline RM, amount of res. used when starting percent of RM. start out with 30-40% --> 60-70%
types of isometric contractions muscle setting (e.g. quad set), stabilization exercise (PNF, Rhythmic stabilization), resisted isometric exercise
how long to hold isometric contraction 6-10 secs
Brime isometric regime 20 max contractions held 6 secs daily with 20 sec rest
davies rule of 10 10 sets, 10 reps everyday, `10 deg for every 10 secs. hold for 10 secs go up 10 degrees and repeat
CI's for isometric exercise? cardiac or vascular disease
What kind of exercise is theraband? high velocity variable dynamic resistance
isokinetic exercise velocity is manipulated, not the load. accomodates to fatigue. short arc b4 long arc`
Progression of closed chain exercise % body weight, BOS, support surface, balance, exclusion of limb movement, plane/direction of movement, speed of movement
What is PRE? system of dynamic resistance when constant external load is applied. rom is used for baseline and progressed.
What is delorme? use of 3 sets of 10 of a 10 rep max with progressive loading each set. builds warm up into program... 50%-75-100%
what is oxford method? uses 10 RM ... 100-75-50
plyometric training high intensity high velocity eccentric to concentric exercises to develop coordination and muscle power
precautions of resistance training valsava, substitutions, overtraining, overwork
what are the signs of DOMS? 1. muscle soreness starting 12-24 hrs peaking 48-72 hrs post exercise 2. tenderness with palpation 3. increased soreness with passive lengthening 4. local edema/warmth 5. muscle stiffness 6. decreased ROM + muscle strength
H20 + temp water retains 1000 X more heat than air and conducts temp 25 X faster increases with velocity
temp for water exercise 26-33 C. 33C for acute MS injuries to relax, elevate pain threshold, and decrease spasm.
what about swimming strokes? elicits higher elevation of HR, BP, v02 max than anything else
% jt. loading and ambulation: c7=10%, xiphoid = 33%, ASIS = 50%
what are the types of tendinopathies?> tenosynovitis (synovial), tendonitis (inflamm of tendon), tenovaginitis (thickening), tendinosis (overuse)
What is the protection phase ? 4-6 days, PROM of affected tissue, AROM above and below, massage, muscle setting, control inflammation.
what is controlled-motion phase? up to 6 weeks .Nondestructive exercise, promote healing and scar formation, isometrics + NM control, muscular endurance + LATER low intensity with high reps with light resistance
what is the chronic stage? up to 6 months or year, progressive stretching, strengthening, endurance + return to function
myofascial pain syndrome chronic regional pains syndrome, trigger point release
What to do for FM? increase aerobic exercise
what is a functional capacity eval? battery of performance tests to determine ability to work, perform ADLs or leisure
tests of function gait performance, functional mobility, body mechanics, UE functional performance, agility and skill, adaptability to environment
When to return a pt to full part of activity? 1. acute signs and symptoms resolved, no pain or edema 2. demonstrated ROM, strength, endurance, proprioception, agility, coordination. 3. activity performed as pre-injury 4. confidence to perform the task
when to start working on NMC? acute stage
best position to train balance QUADRIPED
how should speed + accuracy be addressed TOGETHER, miss mary mack. inversely related
how to test proprioception WB exercise!! anything that stimulates those jt. mechanoreceptors
android obesity abdominal fat --> more risk of disease
gynoid obesity fat around hips + thighs ---> less risk of disease
Waist Hip Ratio (WHR) > ,95 + .86 is high risk
Sub Q fat norms? 10-22 % men 20-32% women
BMI kg/m^2 >25 overweight >30 obese
pilates is important for... kinesthetic awareness, spinal stabilization ex/core strength,
what are the symptoms of Myositis Ossificans? passive extension more limited than flexion, resisted elbow flexion causes pain, heterotopic bone formation, distal brachialis tender.
frozen shoulder dense adhesions and capsular restrictions in dependant fold of capsule. freezing stage (pain)--> frozen stage (atrophy) ---> thawing stage (loss of ROM)
Complex Regional Pain syndrome stage I acute reversible stage characterized by vasodilation lasting 3 weeks - 6 months. major pain, hyperhidrosis, warmth, erythrema, nail growth, and edema in hand
RSD stage II dystrophic vasconstrictive phase lasts 3-6 months. characterized by burning hyperesthesia, intolerance to cold, mottling, brittle nails + osteoporosis
RSD stage III known as atrophic stage characterized by severe osteoporosis, muscle wasting + contractures, can last for months or years with possible spontaneous recovery after 18-24 months.
whats the diff between type I + II? type II has a known nerve injury
common impairments w RSD outrageous pain in shoulder or hand, decrease motion of shoulder w capsular pattern, dec. flex + ext of hand, edema of hand, trophic changes in skin, nail growth or brittleness, atrophy of intrinsic hand muscles, osteoporosis
when is surgery indicated for RTC tear? FULL thickness tears after trial of non-operative management
what are 3 types of rtc repair? arthroscopic, mini approach (split deltoid), traditional open approach ( deltopectoral)
indications for THA severe hip pain, marked limitations in movement, fracture, bone tumors, failure of conservative Tx
THA approaches 1. posterolateral approach - glut max split, highest jt. instability. 2. direct lateral - post op weakness + positive trendelenberg's 3. anterolateral - for ppl with muscle imbalances, hip flexion + IR
goals of acute THA prevent vascular + pulmonary complications + post-op dislocation, achieve functional mobility, maintain strength in UE + unaffected side, prevent reflex inhibition + muscle atrophy of affected side, prevent flexion contracture
Whats the **** is a Q angle? line from ASIS to patella and then from patella to Tib Tub. may be a cause of PFPS.
Where does L3 refer to? anterior knee pain
How to injure the ACL? valgus force to knee OR ER of tibia with forced hyperextension
what is the goal of ACL exercise? restore 90 deg of flexion, and full passive extension by first week. in acute phase, begin muscle setting of quads, hamstrings, hip ABD, ADD
what are the prehension patterns? power grip, precision patterns, combined grips., pinch
whats the closed packed position of the foot? full dorsiflexion
What are the risk factors for FALLS? Balance deficit, muscle weakness, gait deficit, visual deficits, previous history of falls
what are the consequences of inactivity? deconditioning, loss of muscle strength, functional decline, heightened risk of falls, hospitalization
How to correct back pain? first self correct the lateral shift then standing backbend --> prone extension on hard surface
How to fix increased lumbar lordosis dueing gait>? increase abdominal strength, stretch anterior hip flexors, strengthen pelvic floor and hip ADD, stretch + strengthen TFL/ITB
what are the functional leg length discrepancies? circumduction, hip hiking, steppage, vaulting
What can cause long leg during gait? spasticity of extensors, weakness of flexors, locking of knee, foot drop, SI problems
whats the normal walking base>? 50-130 MM
anteroposterior sway limit 12 degrees
lateral sway? standing 4 inches apart, 16 degrees
What is the ankle strategy? functions in anteroposterior plane to restore small perterbations. muscle activation proceeds distal to proximal.
weight shift strategy functions in lateral plane, hips move in lateral plane through abductors and adductors
Hip strategy (IE balance beam) utilized for large or rapid external perterbations. uses rapid hip flexion or extension to move the COM over the BOS. activation is proximal to distal.
stepping strategy (IE stumble) if large force displaces COM beyond the limits of stability --> enlarge BOS by stepping forward.
Whats the best way to stretch? low load long duration yields most significant plastic changes
delorme method use of 3 sets of 10 of a 10 RM with progressive loading each set. builds warm up into exercise ... 50-75-100%
What to do about hip hiking>? strengthen hamstrings
what to do about steppage?` strengthen ankle dorsiflexors
what is vaulting? raising up on toes of opposite limb to clear ground for affected limb
when should you emphasize exhalation? during contraction
Diagnosis Criteria PPS 1. history of paralytic polio 2. partial to complete muscle functional recovery 3. 15 years of stability 4. onset of greater than 2 new health problems 5. no other condition explains symptoms
Created by: llacorte
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